2017-11-21_REPORT - M2013053

• Permit No: M2013053
• IBM Index Class Name: REPORT
• Doc Date: 11/21/2017
• Doc Name: Annual Fee/Report/Map
• From: All-Rite Paving & Redi-Mix, Inc.
• To: DRMS
• Annual Report Year: 2017
• Email Name: MAC
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have
information on record). If this information is blank or not current,please type or print current contact information:
Permittee Contact: John P.Ary
Permittee Company: All-Rite Paving&Redi-Mix,
Inc.
Address: P.O. Box 165
Canon City , CO 81215
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Jodi Schreiber
Company: All-Rite Paving&Redi-Mix Inc.
Address: P.O. Box 165
Canon City, CO 81215
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Inspection Contact: Jodi Schreiber
Company: All-Rite Paving&Redi-Mix Inc.
Address: P.O. Box 165
Canon City, CO 81215
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
I,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are
bein• . .ucted in a cordance with the Division approved mining and reclamation plans.
,,,� 1 14
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Sig re ermittee Cro icer,Owner,or Documented Designee Dat
M-AF-01